[INSERT APPLICANT LETTERHEAD IN HEADER SPACE]
documentation enclosed
*** CORPORATE ENTRY ***
DATE: January 17, 2014
TO: Trade Authority / Program Manager
RE: Participation in Structured Private Financial Opportunity
n Affidavit Requesting Information
n Client Information Sheet
n CORPORATE RESOLUTION
n letter of intent
n SOURCE OF FUNDS AFFIDAVIT
n LETTER OF NON-SOLICITATION & REQUEST
n passport(s)
n proof of funds
n BANK RWA Letter
E-mail, facsimile copies or photocopies of documents or agreements pertaining to this subject are declared and regarded as valid and equal to the original, provided they are represented by proper signatories. Originals may be obtained upon request.
Affidavit Requesting Information
DATE: January 17, 2014
TO: Trade Authority / Program Manager
RE: Participation in Structured Private Financial Opportunity
INVESTOR TRANSACTION CODE:
Dear Sir,
I, (NAME), the undersigned, on my own behalf, do hereby affirm that I have requested specific information about Private Placement Opportunities and or the Participation in Investment Programs. The confidential information presented, received, and learned is not for the solicitation of funds, nor is it an offering of any kind, but is for my general knowledge. I confirm that I have requested the information of my own free will and choice, and further confirm that no party has solicited me in any way. I hereby agree to keep all information received from you strictly confidential, private, and proprietary, and that I will not disclose it to any other third party.
I, (NAME), further affirm that any funds or assets I decide to place are done so at my own specific initiative, risk, and authorization with full consideration and without duress. I further affirm that the information received is intended solely for my PRIVATE & CONFIDENTIAL USE ONLY. I am a sophisticated investor by all definitions of that classification known to me; I make my own investment decisions, and have legally acquired assets available. I, hereby reaffirm, under penalty of perjury that I have requested information from you and your organization and that you have not solicited me in any manner.
I, (NAME), understand that the contemplated transaction is strictly one of Private Placement and is in no way relying upon existing regulations in relation to the United States Securities Act of 1933 as amended, or related regulations, and does not involve the buy and sell of securities. I further declare that I am not a licensed securities broker or government employee and understand that neither are you or your organization. I mutually agree that this Private Placement Transaction is exempt from the securities act.
I, (NAME), understand and agree that the ICC NON-DISCLOSURE and NON-CIRCUMVENTION rules apply to this affidavit and business relationship, and hereby agree to the current application standards of the International Chamber of Commerce, Paris, France which rules are made a part hereof by this reference.
I, (NAME), under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably, confirm that neither myself, nor anyone else associated with my organization, my corporation, or the individual investor are working for any Agencies of any Government. I further state under penalty of perjury that I am not involved in any Government entrapment operation.
I, (NAME), under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably, confirm that neither myself, nor anyone else associated with my organization or corporation have been convicted of a felony, either within the United States or anywhere in the world where that crime would be considered equal to a US felony. To the best of my knowledge I am not nor are any of my associates within my organization or corporation considered to be terrorists or on any watch list with the United States Department of Homeland Security.
I, (NAME), agree that all email and facsimile transmitted documents shall be treated as original documents. I further agree that in all cases where plural might apply where singular tense is used it is so applied.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and true as of this date: January 17, 2014
For and on behalf of (NAME OF COMPANY)
Signature: ______SEAL OF COMPANY
Name / Title:
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
Client Information Sheet
Directions: This document should be completed in full. If a line item does not pertain then insert the term: “N/A” (non-applicable).
Corporate Information
Full Name of Corporation:
Date of Incorporation:
Incorporated in (City/State/Country):
Registration Number:
Board of Directors (Name & Title):
Officers (Name & Title):
Shareholders:
Location of Address: Registered Address (Corporation)
Full Name of Corporation:
Street Address:
City:
State:
Country:
Postal Code:
Location of Address: Mailing Address (Corporation)
Full Name of Corporation:
Street Address:
City:
State:
Country:
Postal Code:
Contact Information (Corporation)
Telephone Number:
Fax Number:
Mobile Number:
Email Address:
Bank Information (Corporate)
Bank Name (where funds are currently on deposit):
Street Address:
City:
State:
Country:
Postal Code:
Account Name:
Account Number:
Sort Code ABA No.:
SWIFT Code:
Account Signatory (1):
Account Signatory (2):
Bank Officer # 1 Name:
Bank Officer # 2 Name:
Telephone Number:
Fax Number:
Client Account where Profits to be paid
Bank Name:
Street Address:
City:
State:
Country:
Postal Code:
Account Name:
Account Number:
Sort Code ABA No.:
SWIFT Code:
Bank Officer Name:
Telephone Number:
Fax Number:
Personal Information of the Transactional Signatory Authorized by Corporation
(Please attach copy of the corporate resolution adopted by the Board of Directors appointing and authorizing said officer(s) below to represent and legally bind the corporation)
First Name:
Middle Name:
Last Name:
Gender:
Date of Birth:
Social Security Number:
Country of Citizenship:
Languages:
Passport Information of Officers(s) of Corporation
*Please attach copy of photo and signature page of passport
Passport Number:
Date of Issue:
Date of Expiry:
Issuing Authority:
Location of Address: Home-Legal Residence (Officer of Corporation)
Full Name of Officer:
Street Address:
City:
State:
Country:
Postal Code:
(You may duplicate the section above for each Director involved in transaction)
Investment
Funds available for this transaction:
Type of currency:
Origin of funds:
Are these funds free and clear of all liens, encumbrances and third party interests:
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and true as of this date: January 17, 2014
For and on behalf of (NAME OF COMPANY)
Signature: ______SEAL OF COMPANY
Name / Title:
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
CORPORATE RESOLUTION
INVESTOR TRANSACTION CODE:
All of the directors of (COMPANY NAME) below listed were in attendance, in person or by telephone conference. General discussion was then held concerning the issue, and all aspects of the same, were fully explained in detail to the satisfaction of the board members.
DIRECTOR Name/Title:
Passport No.:
DIRECTOR Name/Title:
Passport No.:
DIRECTOR Name/Title:
Passport No.:
SECRETARY Name/Title:
Passport No.:
The Board of Directors of (COMPANY NAME), a Company incorporated on (DATE) in (LOCATION) in (COUNTRY), with Registered Offices at (ADDRESS) in a meeting held on this the (Day) Day of (MONTH), (YEAR), adopted the following resolutions.
RESOLUTION 1:
It is resolved that the Board of Directors of (COMPANY NAME) hereby authorizes: (NAME) holder of Passport Number (NUMBER) issued on (DATE);
As our Transactional Managing Member, who currently holds the office of (LIST TITLE, such as President, etc.) with assigned authority, on our behalf stay and name, to instruct, negotiate, arrange, monitor, execute, manage and sign any and all agreements and/or necessary contracts with third parties pertinent to all financial transactions with bank instruments (securities/derivatives)
RESOLUTION 2:
It is resolved that at this meeting of the Board of Directors that our Transactional Managing Member and in fact (NAME) acts for (COMPANY NAME) with regards to the afore said financial investment.
RESOLUTION 3:
It is resolved that (NAME) is hereby authorized to act as our Financial Director for afore said purpose.
RESOLUTION 4:
It is resolved the Board of Directors of (COMPANY NAME) hereby authorized (NAME) to assume all authority, powers, duties, signatory rights and responsibilities on our behalf.
RESOLUTION 5:
It is resolved that (NAME) is hereby authorized to open a personal, corporate, trading, trust and/or custodial account in any bank, domestic or foreign and to sign such resolutions as may be required by such bank to accomplish the objective(s) as stated herein and to give irrevocable instructions to said bank(s) on our behalf.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and true as of this date: January 17, 2014
For and on behalf of (NAME OF COMPANY)
Signature: ______SEAL OF COMPANY
Name / Title:
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
Signature: ______
Name / Title: Secretary
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
LETTER OF INTENT
DATE: January 17, 2014
TO: Trade Authority / Program Manager
RE: Participation in Structured Private Financial Opportunity
INVESTOR TRANSACTION CODE:
Dear Sir,
I, (NAME), the undersigned, hereby confirm under penalty of perjury, my full commitment and agreement to participate in an investment opportunity, subject to my acceptance of the terms, conditions and procedures that shall be outlined in the Private Placement Program.
Furthermore, I hereby warrant and represent that I have available for placement into the proposed investment, the sum of (SPELL AMOUNT) United States Dollars ($_____,000,000.00 USD) of clean, clear funds, free of any levy, liens or encumbrances and of non-criminal origin, and herewith attach documentary evidence of same. I hereby warrant and represent that the Rule of Full-disclosure has established these funds were legally obtained from non-criminal business or actions. I further confirm that I am the beneficial owner of these cash funds, that I have full signatory authority and control thereof, and that such funds are available for immediate placement at my sole discretion.
I confirm and acknowledge, with full responsibility, that neither your company nor anyone working on your behalf has solicited me; that the documents that I shall receive shall not be deemed to be a solicitation of funds in connection with an investment program; and, that I am approaching you voluntarily for the purpose of securing participation in a bona fide Secure Private Placement Program.
I am prepared to instruct my bank to act upon the funds as required pursuant to the specifics of this program. In the case of Blocked Funds, it is my understanding the funds will be blocked and or reserved) in the account and they will remain, at all times, non-callable.
I hereby request information from you covering the terms, condition and procedures of a secured investment and look forward to commencing the transaction, upon my acceptance of the agreement.
Email, facsimile copies or photocopies of documents or agreements pertaining to this subject are declared and regarded as valid and equal to the original, provided they are represented by proper signatories. Originals may be obtained upon request.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and true as of this date: January 17, 2014
For and on behalf of (NAME OF COMPANY)
Signature: ______SEAL OF COMPANY
Name / Title:
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
LETTER OF NON-SOLICITATION & REQUEST
DATE: January 17, 2014
TO: Trade Authority / Program Manager
RE: Participation in Structured Private Financial Opportunity
INVESTOR TRANSACTION CODE:
Dear Sir,
I, (NAME), the undersigned, hereby confirm that I have requested of you and your organization specific confidential information and documentation on behalf of ourselves. I hereby declare that I am fully aware of the information received from you is in direct response to my request, and is not in any way considered or intended to be a solicitation of funds of any sort, or any type of offering, and is intended for our general knowledge only. I hereby affirm under penalty of perjury that you have not solicited in any way. I understand that the contemplated transaction is strictly one of private placement, and is in no way relying on or related to the United States Securities Act of 1933, as amended or related regulations, and does not involve the sale of securities. That affiant makes this affidavit knowing that the recipients will rely on the contents hereof, and agrees to indemnify and hold-harmless all recipients and all other parties -- including intermediaries -- against any and all claims resulting from any applicant misrepresentation of a material fact or any loss of asset value or any act (legal or not) of a bank or other financial institution, governing authority or agency, the Federal Reserve or an official or other insider of any such entity. Further, I hereby declare we are not licensed brokers or government employees, and understand that neither are you or your organization. We mutually agree that this private placement transaction is exempt from the Securities Act, and not intended for the general public, and all materials are for private use only.
For and on behalf of (NAME OF COMPANY)
Signature: ______SEAL OF COMPANY
Name / Title:
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
passport
PROVIDE color COPY ENLARGED (140%) TO THIS SIZE (8½ x 11 INCHES). PICTURE MUST BE CLEAR AND NOT DARK. ENLARGE & LIGHTEN (USING PHOTO SETTING). Color scan the Passport into your computer at a high resolution in the JPEG format and insert.
PROOF OF FUNDS
Current Bank Statement
Current bank statement or recent FIVE (5) days tear sheet is the requested acceptable proof of funds. BCL, bank letters signed by bank officer(s), Certificate of Account or Confirmation of Funds may be included as supplemental banking. Kindly include un‐sanitized current bank statement or tear sheet with your submission. transmit high-quality, color scans of real documents. Thank you.
ON BANK LETTER HEAD
Proof of Funds letter in Draft
DATE : (Date)
TO : …..(Name Corporation or Individual)……
REFERENCE: ACCOUNT NUMBER ………
ACCOUNT NAME:….. NAME CORPORATION OR INDIVIDUAL………
ACCOUNT SIGNATORY: MR………………………….
Dear Mr. … (Name Client)…… :
We, ………….Bank, located at ………………………………in ………., hereby confirm with full bank responsibility and with full legal liability, that you have XXX Hundred Million USD/Euros (USD/Euro XXX,000,000.00) in cash / ASSETS (type of assets) on deposit in the above referenced account. We further confirm that these funds are good, clean, cleared, of non-criminal origin, free of any liens or encumbrances, were legally earned, and are fully transferable.